Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -U0 Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> / �•�7 � / iiK-(o 67-yss 6933 �o <br /> OWNER 13f i`L -4 f5o5E H/4N r I9 t TELEPHONE o,<,- ?5;t `e <br /> m <br /> MAILING ADDRESS �`tJ'Si C��uv N✓ /� /,1pt/E �r HSC/ O <br /> PROPERTYADDRESS D <br /> S'3s _ ry/— R/(,w to TAHNS vs PivEeview pit <br /> LEGAL DESCRIPTION(see tax receipt) 4,x7'9 �M =-' <br /> DWELLING/BUILDING ElGARAGE/ACCESSORY STRUCTURE 1:1 ADDITION ❑ ^ <br /> TYPE OF PERMIT(S): c <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ r sra�r2 r-P�Ar a <br /> STRUCTURE/ADDITION USE: 0 <br /> 0 <br /> (Home/Cabin; Commercial Business;Bedroom; Deck;etc.) C �1 <br /> BUILDING CONTRACTOR: s 7-- !CZ *TTi4 M g&,Zk� 12 <br /> \ 1 <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 CD <br /> O m <br /> T o- <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. T Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE n v <br /> m <br /> NORTH(N). mC <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. Z <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO <br /> BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICA (B_E Dm11YE N O o <br /> NEEDED. ��-� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. r <br /> CONDITIONS OF PERMIT: APR 1 S I o ) <br /> pp / <br /> 1 SSIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERIRORN,�� <br /> 2. REMOVAL OR CUTTING OF TRES AND <br /> 3. NO GRADING OR HO ELAND ALTERATIONS A EIOLLOWED URNLESS SPEC ICTED F CALALONGRYLINE. Zp/V/NG IJA17-y <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> 6. m W 0, MaF m <br /> CL M <br /> 7. ID Z o � On _{ <br /> 9 -n � <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my - r= A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> all information contained in this application(including an accompanyingschedule and 1 further declare that I recognize m o m <br /> PP (� 9 Y ) g <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- i `D C <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am oO <br /> providing <br /> p gin this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. Cy <br /> ` may/ _ 7 L";�,/ m ' m' C <br /> SIGN HERE r✓ s/�/! -�O` �� <br /> signal a of ow Ilding contractor) C. <br /> (date) ((JnJ <br /> ZONING ADMINISTRATOR V I <br /> //,,',' U�q NnJ 69 fA fA fA C3 N <br /> 1rnvUI.0 W N (T N N O O <br /> L� ��/ (TO (T (TOO <br />�U � dLT71Q Z'2 ill TOWNSHIP PERMITS MAY BE REQUIRED BEd <br />